精神科における看護師から患者への暴力，虐待：スコーピングレビュー

Nurse-to-patient Violence and Abuse in Psychiatry: A Scoping Review

要旨

　目的：精神科における看護師から患者への暴力と虐待に関する文献を包括的にレビューし，その特徴と要因を明らかにする．

　方法：PRISMA-ScRに基づき，スコーピングレビューを実施した．文献検索には，PubMed，CINAHL，医学中央雑誌を用いた．文献選定の包含基準は，（1）精神科病棟や外来における看護師から患者への暴力，虐待行為に関する論文，（2）英語または日本語で書かれた論文とした．

　結果：最終的に，12件の文献がレビュー対象となった．暴力や虐待の内容は，暴行，暴言，無視，身体拘束に関する内容であった．暴力や虐待の要因に関する内容は，自分の行為は，ケアであって暴力ではないという思い込み，精神科における閉鎖的な治療環境に関する内容であった．

　結論：本研究結果から，精神科における看護師から患者への暴力，虐待の特徴や要因には，閉鎖性，密室性，強制性という精神科医療における構造的問題があることが示唆された．

　Objective: To comprehensively review the literature on, as well as clarify the characteristics and factors of, nurse-to-patient violence and abuse in psychiatry.

　Methods: A scoping review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). PubMed, CINAHL, and Ichushi Ver.5 databases were used to search for relevant literature. The inclusion criteria for the selection of literature were papers (1) focusing on psychiatric nurse-to-patient violence and abuse in psychiatric inpatient or outpatient department, (2) written in English or Japanese.

　Results: A total of 12 studies were reviewed. The content of violence and abuse was about assault, violent language, neglect, and physical restraint. The content of the causes of violence and abuse were related to assume that psychiatric care is not violence and the closed treatment environment in the psychiatric department.

　Conclusion: The results suggested that the characteristics and factors of nurse-to-patient violence and abuse include structural problems in psychiatry, such as exclusive and closed environment and coerciveness.